Secret Sauce Recipes

chef preparing to cook

A blueprint to identify your practice’s differentiators

By Kenny Erb, PT

“Unique Value Propositions”, “Differentiators”, “Competitive Advantages”, “Secret Sauces”. When it comes to how we understand and communicate the aspects of our business that make it well, special, there are no shortage of descriptors. Here’s my favorite:

“Name one aspect of our practice that makes it stand out in a way that is so different, and so superior, that a consumer is going to choose to come to us over (you choose the alternative)?”

Alternatives abound. Other physical therapy practices, the hospital, POPTS, chiropractors, acupuncturists, the medicine cabinet, massage therapists, personal trainers, athletic trainers, dog trainers — too far? Maybe for some, not so much for others.

Gary Vaynerchuck told us a few years ago, “Don’t be romantic about your business!”1 Vaynerchuck implored us to loosen our grip on what we THINK makes us special…and consider what is actually attracting our consumers. Physical therapists are a passionate bunch. We believe deeply about what makes us, well, us, and how much we have to offer our patients. How can we not be a bit romantic (at least a little flirtatious) about our “secret sauce”? That said, Vaynerchuck had a great message. How wide is the gap between what we think our market loves about our practice, and why they actually choose us? Worse yet, we often believe that this love affair our market has, or once had, with our practice is going to continue forever, unabated.

How can we get in the habit of constantly examining our unique value proposition (UVP)? What do we do if we don’t like what we find? Since we aren’t making soft drinks (Coke’s secret recipe is legendarily kept in a vault in Atlanta) or Big Macs, it might not be so obvious what “secret sauce” might look like in a physical therapy business. Here’s a starting point:

Differentiation refers to how a startup’s offerings are better/faster/cheaper than competitors… However, for business strategy purposes, being superior is not considered an advantage unless you can protect it by preventing copycats. If you cannot protect it, everyone will copy your “advantage” and you’ll have no advantage.2
— Patrick Vernon

Going through the process of revisiting your advantage (UVP) is merely step one. The next step is thinking in terms of what makes your practice so unique that others cannot easily replicate it. The mixing (pun intended) of these is your “secret sauce.” In an industry where the terms of our offerings are almost always narrowly and strictly dictated by regulating bodies, this can prove quite a challenge. As the old saying goes, “There is a relatively limited number of ways that a physical therapist can skin a Medicare cat.” (That’s actually not old, or even a saying, I just fabricated it from whole cloth, but it works!)

In preparing for this article, I interviewed three practice owners of differing sizes from small (one site), to slightly larger (three), to much larger (25+) about what makes their practices special. All have been in practice for more than 20 years. What I got from these conversations was more than I could have hoped for. As always, APTA Private Practice members are generous with their time, their energy, and their general desire to elevate the profession of physical therapy.

In each conversation, one question stood out: “If you can cast your mind, and put yourself back in your own shoes to when you started your practice, what was it that you thought made you special and how does that differ from today?” I would invite you to take 40 seconds off from reading (please come back) and indulge me in that same question yourself:

“What did (insert your age when you started your practice) ______________ year-old (your name here) ____________________ think was the “secret sauce” that YOU were going to bring to the table, that was going to storm the physical therapy world, and how does that differ from what you now know?”

Here were some of the answers from the owners in my research:

“Twenty-four years ago, I thought, all I need is these last couple certifications, and a geeky specialty training, and I’m going to memorize JOSPT, and people will come running in droves. If I can just become the best clinician, that’s the answer. Today, I feel like, well, it’s not about me at all! When it comes to our contributions to the world, the less it’s about me, the more it contributes to the world.”

“I started my business when I was 25. I felt like, ‘I’m here, and I created this clinic because I provide better quality care.’ Now, I know it’s about building relationships with people. Our new ‘why’ is about elevating the quality of care in our region, because our family and friends deserve the best.”

“When I started out I had great relationships with the docs in our area. I’m a natural at making and keeping friends, at relationships, and I was able to cultivate those relationships into a nice little practice where I could deliver on the promises that these docs were making about me. Wow a lot has changed. POPTS, then MD’s having rental agreements with competitors, then HOPTS; if doctor referral was really my driver, I’d be done. I now realize that I sort of had it right; it was my relationship “superpower” that was my difference. Of course, the winning formula in the end was my ability to make and keep relationships with the patients and eventually, as we grew, pivoting that ability toward the staff, and hiring and nurturing people who share core values. I know now that how I treat the staff is how they’ll treat the patients. Those relationships are the key”

Three owners, three different “whys” with some obvious commonalities. Three secret sauces that aren’t hard to understand, but that have worked for their practices. When we consider what makes us special, different, and unique (to the degree that a consumer will choose us) I think we all can agree that, by its very nature, the “Unique” in UVP rings true. Similarly, there’s not an industry-wide checklist or procedure that you can go through to identify your secret sauce. No cookbook protocol that starts with passive range of motion and progresses to eventual return to sport for your business (ugh).

Strategies to identify your secret sauce also abound. Survey your patients. Survey your staff. Ask your biggest referrers. Study your numbers. A practice with a big physician referral network is going to look much different than one who gets patients from direct-to-consumer marketing, pediatrics different than sports medicine, urban different than rural, and so on.

If you’ve made it this far in the article, you’ve already started the process and taken the biggest step. You took time out from your day and meditated for a few seconds on what makes your practice special. Most of us are so busy treating patients, managing staff, arguing with payors, and putting fires out all day every day that we have little time to be introspective about our business. Living in Covey’s “Quadrant 1,”3 we tend to operate like firefighters who never get to go back to the station, eat a bowl of five-alarm chili, and hang out with our dalmatian. I encourage you to take today as a “first step.” You’ve taken a moment to think about your practice, and what makes it special. Budget some time (just 15-30 mins) this week and next week to be strategic and create your own unique process for deciding what it is that makes your business special. Make a plan for identifying and defining (as explicitly as possible) what your UVP is. Write it down. Then plan for how you intend to protect it and turn your UVP into your Secret Sauce.

As you plan to progress, pivot, or protect your secret sauce, make sure to keep your core values in view and acknowledge what you are absolutely unwilling to compromise on. Lastly, make a promise to yourself that you are going to return to this process at regular intervals, every year, three years, or perhaps longer. As always, and as is the best part about private practice, you are the captain of this ship! While our market decides what it likes about us, we each get to chart our own course, in terms of our offerings, how physical therapy will be practiced in our corner of the world, and what effects we hope that it will have on those whom it aims to serve.

A special thanks to the private practitioners who donated their time and energy to this project. 

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1Vaynerchuck, G. APTA Private Practice Keynote. November 11, 2015. Orlando FL.

2Vernon P. How to Think Like a Venture Capitalist.

3Indeed. “Covey Time Management Matrix Explained.” Updated, September 14, 2020.

Kenny Erb, PT

Kenny Erb, PT, is an APTA Private Practice member and an owner of Erb Physical Therapy PC in Pittsburgh, PA; VP of APTA-PA; and teaches at Duquesne University. He can be reached at

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